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Beacon Psychology Services LLC; 11495 N. Pennsylvania, Suite 105; Carmel, IN 46032
(317) 942-4020
© 2022 Beacon Psychology Services LLC
You may need a PDF reader to view and print the forms on this page.
You can download a free one HERE.
Please print out and complete these three forms for your child's first appointment, or click the Online Registration button:
(not needed for your initial appointment)
If there are school-based issues, please print out this form and have your child's teacher complete:
This form gives your consent for us to communicate with specific agencies/individuals regarding our services to you:
(not needed for your initial appointment)
General Information:
(All forms as well as Telehealth Consent form are combined
for online registration)
If you are an 18 or over, please print and complete these two forms for your first appointment.
If you wish to have a session via phone, Facetime, etc., please print and fill out this form or click the Online Form button:
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